• The Journal of the Convergence on Culture Technology
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• v.10 no.3
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• pp.667-673
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• 2024

This study aims to diagnose the issues arising from the relationship between the out-of-pocket maximum in health insurance and private indemnity health insurance and propose policy tasks for institutional improvement. Through literature research, the study analyzed the damage to consumers caused by the non-payment of refunds exceeding the out-of-pocket maximum and the changing role of indemnity insurance due to the strengthening of health insurance coverage. The results confirmed that unilateral interpretation of insurance clauses and incomplete sales practices infringe upon consumer rights, and that insurance premiums do not decrease despite the reduction in coverage of indemnity insurance. Therefore, the study emphasized the urgency of institutional improvements such as rationalization of product structure, transparency of risk rate calculation, and reinforcement of consumer information provision, as well as the need for social consensus on the rational division of roles between health insurance and private insurance. This study is significant in that it provides policy implications for the developmental reorganization of the healthcare system.

• The Southeast Asian review
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• v.28 no.1
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• pp.173-218
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• 2018

This study focuses on the healthcare sector in Vietnam which is promoting universal health insurance for the achievement of Universal Health Coverage (UHC) under Sustainable Development Goals (SDGs). The purpose of this study is to examine the characteristics of the reform process of the health care system and the law on health insurance through the historical and cultural contexts and its implications from the perspective of development. Based on the three dimensions of UHC - extension of protection for population, provision of various medical services, and financial protection, the current status of the Vietnam healthcare sector is summarized respectively as follows. First, according to the revised Health Insurance law which came into effect in 2015, the mandatory health insurance premiums are calculated based on household units. Second, there is a medical network that can provide preventive and healthcare services centered on primary health care facilities, for example commune health stations (trạm y $t{\hat{e}}$ $X{\tilde{a}}$). Third, out-of-pocket expenditure is still a large proportion although public spending has increased and private spending has decreased since the enforcement of the health insurance law and various schemes. Vietnam is currently striving towards a universal health care system. The development of institutions and systems should be designed in a way that is appropriate for the members of the society rather than efficiency. This article findings shed light on the role of social values, family culture, and informal institutions.

• Journal of the Economic Geographical Society of Korea
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• v.21 no.1
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• pp.1-19
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• 2018

This study aims to analyze the regional patterns of user-provider in medical services for spatial improvement of national health care delivery system in south Korea. By using the National Health Insurance Service National Sample Cohort DB, the characteristics and changes in the medical service cases served outside of residing regions are found. In 2013 the rate of the cases served outside of residing regions was declined slightly and users of medical institutions outside of their residing area tended to have high income level relatively and to visit hospitals than clinics. And departments visited have changed from 2002.

• Ceramist
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• v.7 no.1
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• pp.61-65
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• 2004

새로 시작된 21세기, 우리나라를 비롯한 OECD 국가들의 정책 방향을 결정하는데 있어서 가장 중요한 지표로 대두되는 것 중의 하나가 국가를 이루고 있는 국민 개개인의 행복 추구라고 할 수 있다. 각 개인이 건강하고 윤택한 생활을 보장받기 위해서는 국가의 사회복지 제도의 개선과 함께 살아가는 과정에서 부딪히게 되는 재난 또는 사고로부터 개인의 불행을 최소화하는 시스템 지원과 불가피하게 찾아오는 사고나 질환 혹은 노화에 대비해 신체적 장애를 극복할 수 있는 의료체계의 확립이 필수적이라고 할 수 있다. 특히 우리나라와 같이 고령화 사회로의 전이가 급속히 진행되고 있는 개발도상국에서는 의료체계가 단순한 생명 연장이 아니라 사회 구성원으로써의 역할을 다할 수 있도록 지원해주는 방향으로 재건할 필요가 있다.(중략)

• Industry Promotion Research
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• v.9 no.2
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• pp.95-102
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• 2024

This study aims to compare the role of the public sector in the U.S. and Korean medical security systems and study response measures in the social risk situation of the COVID-19 virus. The COVID-19 pandemic was a typical case of a 'disaster' that spread across the world across borders in a short period of time and caused serious social welfare losses by increasing the annual number of deaths by approximately 4% in 2020. Threats to health security, such as changes in social order, unpredictable endings, prolonged control of daily life, and deepening inequality, affected the economy, politics, and environment as a whole, and people had to experience anxiety and confusion due to mental and physical stress. Furthermore, developed countries failed to provide help to low-income countries in the face of global disasters. In this situation, the country's disaster management capacity to minimize harm and secure resilience, especially disaster response capacity in the health and medical field, is inevitably very important. Therefore, this study compares how the health insurance system, which is a system to guarantee citizens' right to life, differs from the United States, a liberal health care country, and raises the need to strengthen the role of the public sector.

• Journal of KIISE:Software and Applications
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• v.37 no.12
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• pp.871-881
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• 2010

Objective: A clinical contents model is an essential data model to exchange clinical data, among existing computer systems and enhance consistency of necessary data, in terms of its meaning and reusability. However, there has not been a domestic case where such clinical model is developed till present. Methods and Results: This research is based on determining principles of developing clinical information model which is a specified model of Health level 7 Reference Information Model and attempts to identify clinical contents with types of ENTITY-ATTRIBUTE-VALUE, based on terminology standard by clinicians and domain modelers. Conclusion: This model is projected to be utilized in the next generation of EMR as core contents.

• The Journal of the Korea Contents Association
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• v.13 no.4
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• pp.170-186
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• 2013

As the population is getting older, medical expenses amount of the whole is keep increasing. So, the pressure of the finances, Health Insurance, Medical Care Assistance Act and etc, is getting higher. The share of healthcare-expense is increasing due to elderly illness. And it became a social problem; we analysed present state of senior healthcare in South Korea-looked into current laws and policies, and found problems. We tried to suggest improvements that drew from the current state of foreign country senior healthcare of those problems. For the result, we found the problem in relevant-law system of senior healthcare guarantee. In this study, we proposed the ways to qualitatively upgrade of medical standard that considered on elderly' features: the strengthened guarantee for healthcare, financial secure for long-term convalescence benefit, linking and functional reinforcement for elderly welfare and long-term convalescence insurance, the solution for overlapped laws about convalescence in long-term convalescence insurance and elderly welfare, a betterment of grading, and a home service consolidation. We need to secure right amount of emergency medical service budget, and effective management system for the improved level of senior severely emergency medical service. Furthermore, we suggested that South Korea needs to legislate [The Law for Senior Medical Secure] to respond to rapidly increasing senior healthcare fee.

• The Korean Society of Law and Medicine
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• v.22 no.3
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• pp.125-144
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• 2021

The purpose of this study is to present a legal improvement plan for health protection of the health-vulnerable class in our society in the 'COVID-19'. The contents of the first study examined the meaning of the existing (social) vulnerable class, and then critically considered the health-vulnerable class as an expanded concept in connection with the social risk of health. The term "vulnerable class" tends to have both meaning as the traditionally marginalized class such as the elderly, the disabled, and women, as well as the condition of having no ability to live due to low income, such as the low-income class. The concept of the health-vulnerable class is meaningful in that it appears as a recently expanded concept as it is linked to the concept of the vulnerable class and social risks such as health threats. The content of the second study looked at the problems that appeared when the health-vulnerable class was used together with the health care-vulnerable class in laws. Due to the laws used in both terms, there was a problem that the social security system related to health and health care could create blind spots. The contents of the third study suggested legal improvement directions for social security measures for health for the underprivileged.

• Journal of Digital Convergence
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• v.14 no.4
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• pp.231-237
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• 2016

The private health insurance covers areas that are not covered by the national health insurance to reinforce insurance guarantee. Realistically, however, many people renunciate small sum insurance claims because the inconvenient claim procedures require a certificate from the hospital for resubmission to the insurance company, which is very time consuming. Therefore, One-stop insurance payout claiming system that is capable of one stop processing of the issuance of e-page safer technology-based certification to claiming of insurance payout by utilizing authorized electronic address (#-mail) through the utilization of private information concealment technology and identification certification technology for the convenience of the subscribers and the simplification of operation was developed.

• Proceedings of the Korean Society of Computer Information Conference
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• 2013.01a
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• pp.299-300
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• 2013

의료시장의 무한경쟁과 의료 경영환경을 극복하기 위한 최선의 방안은 병원 업무의 전산화를 통한 시스템 간의 효율적인 정보교환의 필요성이 대두되고 있다. 또한, 처방전달시스템, 전자의무기록시스템, 검사정보시스템, 의료영상 저장 및 전송시스템 등의 이기종간 의료정보 시스템의 통합 시스템을 구축하여 진료환경을 구축하고 진료의 효율성을 개선해야 할 것이다. 본 논문에서는 업무 시스템 간에 상호 연계가 보장된 표준정보연계체계 구축 및 최적화된 응용시스템 구축으로 환자 서비스 개선과 진료 및 경영 효율을 증대시킨 통합의료정보시스템의 구축방안에 대하여 연구하였다.